Positive Psychology Intervention to Treat Diabetes Distress in Teens with T1D

积极心理学干预治疗 1 型糖尿病青少年的糖尿病困扰

• 批准号: 10379951
• 负责人: Sarah Sanders Jaser
• 金额: $ 48.63万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10379951
• 关键词: Academic Medical Centers; Address; Adolescent; Adult; Affect; American; Back; Basic Behavioral Science; Behavior; Behavior Therapy; Behavioral; Caregivers; Caring; Child; Cognitive; Complex; Conflict (Psychology); Coping Skills; Diabetes Mellitus; Distress; Education; Educational Intervention; Enrollment; Environment; Ethnic Origin; Exercise; Face; Family; Feeling; Glycosylated hemoglobin A; Goals; Health; Injections; Insulin; Insulin-Dependent Diabetes Mellitus; Intervention; Intervention Trial; Link; Measures; Medical center; Mental Depression; Multi-Institutional Clinical Trial; Nature; Outcome; Persons; Pilot Projects; Population; Problem Solving; Psychology; Pump; Quality of life; Race; Randomized; Randomized Controlled Trials; Recommendation; Reporting; Research; Risk; Sampling; Self Care; Self Management; Series; Site; Stress; Teenagers; Testing; Text Messaging; Time; Treatment Efficacy; Treatment Protocols; base; clinical research site; clinically significant; coping; design; diabetes distress; diabetes management; efficacious intervention; efficacy evaluation; emotional distress; experience; glucose monitor; glycemic control; gratitude; improved; improved outcome; innovation; intervention effect; meetings; novel; novel strategies; pleasure; positive emotional state; psychoeducational intervention; psychosocial; randomized trial; response; satisfaction; sex; stress management; tailored messaging; theories

PROJECT SUMMARY Adolescents with type 1 diabetes (T1D) struggle to meet treatment goals – only 17% met the target for glycemic control in a recent national study – and many adolescents experience high levels of diabetes distress related to the daily demands of diabetes care. Yet, previous interventions to improve glycemic control in adolescents with type 1 diabetes have only shown modest to moderate effects, and many have been time- intensive and expensive. Thus, there is a need for novel interventions to improve outcomes in adolescents with T1D. Increasing positive affect, or pleasurable engagement with the environment (e.g., feeling happy, cheerful, proud), has been shown to promote the use of more adaptive coping strategies to manage stress. Thus, the proposed study is based on the premise that, by boosting positive affect in teens with diabetes, we will enhance the use of adaptive coping strategies and reduce diabetes distress, thereby improving glycemic control in adolescents. Through an iterative series of pilot studies, our research team adapted a behavioral intervention using a positive psychology framework that we demonstrated to be feasible and acceptable for adolescents with T1D. This intervention is aimed at inducing positive affect in adolescents (age 13-17) through empirically-validated, tailored exercises in gratitude, self-affirmation, and caregiver affirmations. In our pilot studies, the intervention had promising effects on adolescents' quality of life, diabetes-related stress, and family conflict, all of which are closely linked with diabetes distress. We now plan to evaluate the efficacy of the intervention in a multisite, randomized controlled trial. The aims of this study are to 1) evaluate the effects of a positive psychology intervention for adolescents (age 13-17) and their caregivers on glycemic control; 2) evaluate the effects of the intervention on diabetes distress, coping, and self-care behavior; and 3) explore the differential impact of intervention effects across demographic and treatment variables. We plan to randomize 200 adolescent-caregiver dyads to the Positive Affect + Education intervention (n=100) or the Education only intervention (n=100) from two clinical sites (Vanderbilt University Medical Center and Children's National Medical Center). By employing a positive psychology framework, we propose an innovative approach to treat diabetes distress and improve glycemic outcomes. We believe this novel intervention has the potential to improve outcomes in adolescents with T1D, and the use of automated text messaging to deliver the intervention offers possibilities for wide dissemination.

项目摘要 患有1型糖尿病（T1D）的青少年难以实现治疗目标 - 只有17％的人满足了目标 在最近的一项国家研究中，血糖控制 - 许多青少年经历了高水平的糖尿病困扰 与糖尿病护理的日常需求有关。然而，以前改善血糖控制的干预措施 患有1型糖尿病的青少年仅显示适度至中度影响，许多糖尿病的影响是时间 - 密集且昂贵。那是需要新颖的干预措施来改善青少年的结局 T1D。增加积极影响，或与环境的愉快互动（例如，感到快乐，开朗， 骄傲的），已被证明可以促进使用更适应性应对策略来管理压力。那， 拟议的研究基于这样的前提，即通过提高糖尿病青少年的积极影响，我们将 增强适应性应对策略的使用并减轻糖尿病困扰，从而改善血糖 在青少年中控制。通过一系列迭代的试点研究，我们的研究团队适应了行为 使用积极的心理学框架进行干预，我们证明是可行的，可以接受 具有T1D的青少年。这种干预旨在通过 经过经验验证，量身定制的练习，以感恩，自我肯定和照料者的肯定。在我们的飞行员中 研究，干预措施已承诺对青少年的生活质量，与糖尿病相关的压力和 家庭冲突，所有这些都与糖尿病困扰密切相关。我们现在计划评估 干预多站点，随机对照试验。这项研究的目的是1）评估 青少年（13-17岁）及其对血糖控制的护理人员的积极心理学干预； 2） 评估干预对糖尿病困扰，应对和自我保健行为的影响； 3）探索 干预效果在人口统计和治疗变量之间的差异影响。我们计划随机化 200个青少年照顾者二元组为积极影响 +教育干预措施（n = 100）或仅教育 干预（n = 100）来自两个临床部位（范德比尔特大学医学中心和儿童国家 医疗中心）。通过采用积极的心理学框架，我们提出了一种创新的方法来治疗 糖尿病困扰并改善血糖结果。我们相信这种新颖的干预有可能 改善T1D青少年的结果，并使用自动文本消息传递 干预为广泛传播提供了可能性。

项目成果

Evaluation of Study Engagement With an mHealth Intervention (THR1VE) to Treat Diabetes Distress in Teens With Type 1 Diabetes: Randomized Clinical Trial.

• DOI: 10.2196/47089
• 发表时间: 2023-10-05
• 期刊: JMIR pediatrics and parenting
• 影响因子: 3.7

Importance of caregivers' subjective social status and neighbourhood disadvantage for adolescents with type 1 diabetes.

照顾者的主观社会地位和邻里劣势对于患有 1 型糖尿病的青少年的重要性。

• DOI: 10.1111/dme.15097
• 发表时间: 2023
• 期刊: Diabetic medicine : a journal of the British Diabetic Association
• 作者: Mackie,Tayler;Morrow,TroyD;Abadula,FayoJ;Jaser,SarahS
• 通讯作者: Jaser,SarahS

Updating Our Understanding of Device Use in Adolescents: Demographic Factors and Preferences in a Group of Adolescents With Type 1 Diabetes.

更新我们对青少年设备使用的理解：1 型糖尿病青少年群体的人口统计因素和偏好。

• DOI: 10.1177/26350106231220023
• 发表时间: 2024
• 期刊: The science of diabetes self-management and care
• 作者: Garretson,Sydney;Parmar,Angelee;Streisand,Randi;Jaser,Sarah;Datye,Karishma
• 通讯作者: Datye,Karishma

A Pandemic Perspective: Analyzing the Impact of COVID-19 on Diabetes Management and Mood Through the Lens of Location and Family Conflict.

• DOI: 10.1177/26350106221094525
• 发表时间: 2022-06
• 期刊: SCIENCE OF DIABETES SELF-MANAGEMENT AND CARE
• 影响因子: 1.9
• 作者: Moore, Hailey;Abadula, Fayo;Garretson, Sydney;Okonkwo, Nkemjika;Streisand, Randi;Jaser, Sarah
• 通讯作者: Jaser, Sarah